National Cancer Institute


Posted Date: Jul 3, 2008

TABLE OF CONTENTS


Description

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What are pituitary tumors?

Pituitary tumors are tumors found in the pituitary gland, a small organ about the size of a pea in the center of the brain just above the back of the nose. The pituitary gland makes hormones that affect growth and the functions of other glands in the body. Pituitary tumors may be grouped as follows:

  • Benign adenomas, which are noncancer. These grow very slowly and do not spread from the pituitary gland to other parts of the body.
  • Invasive adenomas, which spread to the outer covering of the brain, bones of the skull, or the sinus cavity below the pituitary gland.
  • Carcinomas, which are malignant (cancer). These are pituitary tumors that have spread far from the pituitary gland in the central nervous system (brain and spinal cord) or outside of the central nervous system.

These pituitary tumors may be either functioning or nonfunctioning. Tumors that make one or more of the pituitary hormones are called functioning tumors, while those that do not make hormones are called nonfunctioning tumors. Each type of functioning tumor causes different symptoms, depending on the type of hormone that is being made by the tumor. Symptoms may also be caused if the tumor grows large and presses on nearby parts of the brain. A doctor should be seen if there are symptoms such as these:

  • Headaches.
  • Trouble seeing or moving the eyes.
  • Vomiting.
  • Any of the symptoms caused by too many hormones, as described under the tumor types in the Stage Explanation section.

Some cancers in other parts of the body may metastasize (spread) to the pituitary gland, but these pituitary tumors usually do not cause symptoms. Breast and lung cancer are the most common types of cancer that spread to the pituitary.

If there are symptoms, a doctor may order laboratory tests to see what the hormone levels are in the blood. The doctor may also order an MRI (magnetic resonance imaging) scan, which uses magnetic waves to make a picture of the inside of the brain. Other special x-rays may also be done.


Stage Explanation

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Types of pituitary tumors

Pituitary tumors are classified according to size:

  • Microadenomas are smaller than 10 millimeters.
  • Macroadenomas are 10 millimeters or larger.

Most pituitary adenomas are microadenomas.

Once a pituitary tumor is found, more tests will be done to find out how far the tumor has spread, the type of tumor, and whether or not it makes hormones. Treatment of the tumor depends on these factors and also on the symptoms caused by the tumor and the patient's age and general health. The following types of pituitary tumors are found:


Prolactin-producing tumors

These tumors make prolactin, a hormone that stimulates a woman's breasts to make milk during and after pregnancy. Prolactin-secreting tumors can cause the breasts to make milk and menstrual periods to stop when a woman is not pregnant. In men, prolactin-producing tumors can cause impotence.


ACTH-producing tumors

These tumors make a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to make glucocorticoids. When the body makes too much ACTH, it causes Cushing disease. In Cushing disease, fat builds up in the face, back, and chest, and the arms and legs become very thin. Another symptom of ACTH-producing tumors is weakened bones.


Growth hormone-producing tumors

These tumors make growth hormone. Too much growth hormone can cause acromegaly (the hands, feet, and face are larger than normal) or gigantism (the whole body grows much larger than normal).


Nonfunctioning pituitary tumors

Nonfunctioning tumors do not produce hormones. Symptoms such as headache or trouble seeing may be caused by the tumor pressing on nearby brain tissue. If the tumor presses on or destroys parts of the pituitary gland, the pituitary gland may stop making one or more of its hormones. Lack of a certain hormone will affect the work of the gland or organ that the hormone controls. For example, if the pituitary gland stops making the hormone that affects the ovaries, the ovaries will not work normally or will not develop normally in a child.


Thyroid-stimulating hormone-producing tumors

These tumors make thyrotrophin, which stimulates the thyroid gland to make thyroid hormone. The thyroid hormone helps regulate heart rate, body temperature, the level of calcium in the blood, and the rate at which food is changed into energy. Too much thyroid hormone can cause rapid heartbeat, weight loss, and other symptoms. Thyroid-stimulating hormone-producing tumors may be large and may spread. They sometimes also make growth hormone and/or prolactin.


Pituitary carcinomas

These tumors usually grow quickly and make hormones, commonly ACTH and prolactin. Symptoms may be caused by the hormone that is made by the tumor and by the tumor pressing on nearby brain tissue.


Other pituitary tumors

For information about other types of pituitary tumors, refer to the following PDQ® summaries:


Recurrent pituitary tumors

Recurrent disease means that the tumor has come back (recurred) after it has been treated. It may come back in the pituitary gland or in another part of the body.


Treatment Option Overview

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How pituitary tumors are treated

Different types of treatment are available for patients with pituitary tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Three kinds of standard treatment are used:

Surgery is a common treatment of pituitary tumors. A doctor may remove the tumor using one of the following operations:

  • Transsphenoidal surgery removes the tumor through a cut in the nasal passage.
  • A craniotomy removes the tumor through a cut in the front of the skull.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation for pituitary tumors usually comes from a machine outside the body (external radiation therapy). Clinical trials are testing stereotactic radiation surgery, in which radiation is aimed to the tumor only, with less damage to healthy tissue. A CT scan or MRI is used to find the exact location of the tumor. A rigid head frame is attached to the skull and high-dose radiation is directed to the tumor through openings in the head frame, so only a small amount of normal brain tissue is affected. This procedure does not involve surgery. Radiation therapy may be used alone or in addition to surgery or drug therapy.

Drug therapy is the use of drugs to stop the pituitary gland from making too many hormones.


Treatment in a clinical trial

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. In the following lists of treatments for the different types of pituitary tumors, a link to search results for current clinical trials is included for each section. These have been retrieved from NCI's clinical trials database. For some types of tumors, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.


Prolactin-Producing Pituitary Tumors

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Treatment may be one of the following:

  1. Drug therapy to stop the tumor from making prolactin.
  2. Surgery to remove the tumor (transsphenoidal surgery or craniotomy) when the tumor does not respond to drug therapy or when the patient cannot take the drug.
  3. Radiation therapy.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


ACTH-Producing Pituitary Tumors

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Treatment may be one of the following:

  1. Surgery to remove the tumor (usually transsphenoidal surgery) with or without radiation therapy.
  2. Radiation therapy alone.
  3. Drug therapy to stop the tumor from making ACTH.
  4. A clinical trial of stereotactic radiation surgery.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


Growth Hormone-Producing Pituitary Tumors

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Treatment may be one of the following:

  1. Surgery to remove the tumor (usually transsphenoidal surgery).
  2. Drug therapy to stop the tumor from making growth hormone.
  3. Surgery followed by radiation therapy.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


Nonfunctioning Pituitary Tumors

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Treatment may be one of the following:

  1. Surgery to remove the tumor (transsphenoidal surgery or craniotomy) followed by watchful waiting (closely monitoring a patient's condition without giving any treatment until symptoms appear or change). Radiation therapy is given if the tumor comes back.
  2. Radiation therapy.
  3. Surgery followed by radiation therapy.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


Thyroid-Stimulating Hormone-Producing Tumors

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Treatment may be one of the following:

  1. Surgery to remove the tumor (usually transsphenoidal surgery) with or without radiation therapy.
  2. Drug therapy to stop the tumor from making hormones.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


Pituitary Carcinomas

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Treatment is usually palliative, to relieve symptoms and improve the patient's quality of life. Treatment may be one of the following:

  1. Surgery to remove the cancer (transsphenoidal surgery or craniotomy) with or without radiation therapy.
  2. Drug therapy to stop the tumor from making hormones.
  3. Chemotherapy.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.


Recurrent Pituitary Tumors

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Treatment of recurrent pituitary tumor depends on the type of tumor, the type of treatment the patient has already had, and other factors such as the patient's general condition. Patients may want to take part in a clinical trial of new treatments. Treatment may be one of the following:

  1. Radiation therapy.
  2. A clinical trial of stereotactic radiation surgery.

Check for U.S. clinical trials from NCI's PDQ® Cancer Clinical Trials Registry that are now accepting patients with recurrent pituitary tumor.


To Learn More About Pituitary Tumors

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For more information from the National Cancer Institute about pituitary tumors, see the Pituitary Tumors Home Page.

For general cancer information and other resources from the National Cancer Institute, see the following:


Get More Information From NCI

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Call 1-800-4-CANCER

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Chat online

The NCI's LiveHelp online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write to us

For more information from the NCI, please write to this address:

  • NCI Public Inquiries Office
  • Suite 3036A
  • 6116 Executive Boulevard, MSC8322
  • Bethesda, MD 20892-8322

Search the NCI Web site

The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our Best Bets search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.

Find Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.


Changes to This Summary (07/03/2008)

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The PDQ® cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.


About PDQ®

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PDQ® is a comprehensive cancer database available on NCI's Web site.

PDQ® is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ® is available online at NCI's Web site. PDQ® is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ® contains cancer information summaries.

The PDQ® database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ® cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ® also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Listings of clinical trials are included in PDQ® and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ®. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


News
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Jan 31, 2013 - Early palliative care clinic visits, integrated with standard oncologic care for patients with metastatic lung cancer, emphasize symptom management, coping, and psychosocial aspects of illness, according to research published online Jan. 28 in JAMA Internal Medicine.



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